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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Adult mortality and probable cause of death in rural northern Malawi in the era of HIV treatment
Tropical Medicine and International Health, Volume 17, No. 8, Year 2012
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Description
Objectives Developing countries are undergoing demographic transition with a shift from high mortality caused by communicable diseases (CD) to lower mortality rates caused by non-communicable diseases (NCD). HIV/AIDS has disrupted this trend in sub-Saharan Africa. However, in recent years, HIV-associated mortality has been reduced with the introduction of widely available antiretroviral therapy (ART). Side effects of ART may lead to increased risk of cardiovascular diseases, raising the prospects of an accelerated transition towards NCD as the primary cause of death. We report population-based data to investigate changes in cause of death owing to NCD during the first 4years after introduction of HIV treatment. Methods We analysed data from a demographic surveillance system in Karonga district, Malawi, from September 2004 to August 2009. ART was introduced in mid-2005. Clinician review of verbal autopsies conducted 2-6weeks after a death was used to establish a single principal cause of death. Results Over the entire period, there were 905 deaths, AIDS death rate fell from 505 to 160/100000 person-years, and there was no evidence of an increase in NCD rates. The proportion of total deaths attributable to AIDS fell from 42% to 17% and from NCD increased from 37% to 49%. Discussion Our findings show that 4years after the introduction of ART into HIV care in Karonga district, all-cause mortality has fallen dramatically, with no evidence of an increase in deaths owing to NCD. © 2012 Blackwell Publishing Ltd.
Authors & Co-Authors
Chihana, Menard
Unknown Affiliation
Floyd, Sian
Unknown Affiliation
Molesworth, Anna M.
Unknown Affiliation
Crampin, Amelia Catharine
Unknown Affiliation
Kayuni, Ndoliwe
Unknown Affiliation
Price, Alison J.
Unknown Affiliation
Zaba, Basia W.
Unknown Affiliation
Jahn, Andreas
Unknown Affiliation
Mvula, Hazzie
Unknown Affiliation
Dube, Albert
Unknown Affiliation
Ngwira, Bagrey M.M.
Unknown Affiliation
Glynn, Judith R.
Unknown Affiliation
French, N.
Unknown Affiliation
Statistics
Citations: 43
Authors: 13
Affiliations: 3
Identifiers
Doi:
10.1111/j.1365-3156.2012.02929.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Infectious Diseases
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Locations
Malawi